Provider Demographics
NPI:1831231612
Name:PHILADELPHIA HEALTH MANAGEMENT CORP
Entity type:Organization
Organization Name:PHILADELPHIA HEALTH MANAGEMENT CORP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:BILLING COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:SHANTE
Authorized Official - Middle Name:
Authorized Official - Last Name:PENNINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-731-2042
Mailing Address - Street 1:1200 CALLOWHILL ST
Mailing Address - Street 2:SUITE 102
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19123-3604
Mailing Address - Country:US
Mailing Address - Phone:215-731-2042
Mailing Address - Fax:267-765-2380
Practice Address - Street 1:1200 CALLOWHILL ST
Practice Address - Street 2:SUITE 102
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19123-3604
Practice Address - Country:US
Practice Address - Phone:215-731-2042
Practice Address - Fax:267-765-2380
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1000016640036Medicare ID - Type UnspecifiedCHANCES